What Actually Happens In An Eye Movement Desensitization and Reprocessing (EMDR) Therapy Session?
Written by Colter Bloxom, LPC
Colter is a licensed psychotherapist and the owner and Executive Director of Thrive Therapy. He specializes in the treatment of anxiety, OCD, identity issues, and more.
You may have heard about eye movement desensitization and reprocessing (EMDR), a very effective treatment for post-traumatic stress disorder (PTSD). But if you’re considering it, it’s normal to wonder what it actually looks like in real life — what you’ll be asked to do and what actually happens during a session.
EMDR can sound a little unusual at first, but once you understand the structure, it tends to feel much more straightforward and approachable.
Thrive Therapy's team of licensed therapists provides EMDR therapy in Phoenix and Glendale, AZ. Get in touch with us to get matched with the right therapist for you! We accept most insurance plans.
3-hour EMDR Intensives also available!
What is EMDR therapy?
EMDR is a form of therapy that was originally created by Francine Shapiro to help people process traumatic memories. It's not talk therapy. You will be talking to your therapist, but talking through problems isn't the primary way that EMDR helps you.
EMDR targets both sides of your brain, in a process called bilateral stimulation, to help you move through and process trauma that might be difficult to talk about. The goal of EMDR therapy is to desensitize you to the distress of the traumatic experience. You won't forget it, but it'll no longer bring up such intense emotions.
Usually, this bilateral stimulation comes in the form of eye movements --- moving your eyes from left to right. But sometimes, therapists may use tapping, sounds, or other methods to stimulate both sides of your brain.
Scientists still don't understand exactly how EMDR works --- but research shows that bilateral stimulation helps you get to that point. The important thing is that it's effective. Over 30 randomized controlled trials have found that EMDR is effective.
On top of PTSD, research suggests EMDR can also help with:
- Obsessive-compulsive disorder (OCD)
- Eating disorders
- Somatoform disorders
- Substance use disorder
- Personality disorders
- Mood disorders (like depression and bipolar)
- Anxiety disorders
What does the first session of EMDR look like?
We don't begin bilateral stimulation immediately in the first EMDR session. The first session isn't about processing traumatic memories --- it's about building trust and allowing your therapist to gather knowledge so they can come up with a helpful treatment plan for you.
During your first session --- and for some people, the first several sessions --- your therapist will also focus on building emotional safety. Even though you're not talking about traumatic events, your brain will still be processing them. This can bring up a lot of painful emotions and memories.
It's essential for you to have the skills to be able to cope with any emotional distress that comes up for you as you move through EMDR. Your therapist will never start to process these memories with you until they feel confident that you're capable of handling it.
Here are some of the more specific things you can expect during your first session:
- You will discuss your treatment goals and what brought you into EMDR. You don't need to go into the specifics of the traumatic event. But it's helpful for your therapist to understand what you're hoping for.
- Your therapist will ask you questions about your current symptoms. For example, they may ask about your sleep, your mood throughout the day, how often you feel anxious or on edge, and whether you’re experiencing things like flashbacks or intrusive memories. They may also ask you about your past experiences with mental health treatment, including therapy, medication, and hospitalizations.
- They may ask additional questions about your current living situation, relationships, and so on. Sometimes, if you're currently in an acute crisis or experiencing continuing abuse or trauma, it may not be the best time to start EMDR therapy.
- Your therapist will explain the phases of EMDR and what to expect as you move through sessions together. This can make sure your expectations are realistic.
- You will have the opportunity to ask questions about the process. If you have any fears or concerns about how you'll feel during EMDR, this is the time to share them!
In addition, there may be some paperwork to fill out and sign, just like with any first therapy session.
What happens in an EMDR session (bilateral stimulation)?
Once your therapist decides you're ready, you'll move into the reprocessing part of EMDR, which is the key component of therapy.
During each reprocessing session, your therapist will ask you to focus on the memory of a specific traumatic experience. The more detailed, the better --- you'll be asked to focus on the emotions, thoughts, and physical sensations you experienced during the event, as well as what you saw, heard, and smelled.
Once you have the memory in mind, your therapist will guide you to move your eyes back and forth. Some therapists ask you to visually track their fingers, Others have an electric light or other visual aids that you can follow. Your therapist may also use a different method, like having you listen to a tone that plays in one alternating ear at a time.
You'll be asked to focus on both the eye movements and the traumatic memory at the same time. Neither you nor your therapist will talk much during these sessions, but they may ask you some brief questions or provide direction.
You'll continue for around 30 seconds at a time, until the distress (fear, panic, disgust, shame, etc.) you feel significantly reduces and you feel calm --- ideally, down to no distress at all.
The eight phases of EMDR therapy
Eye movements are an important part of EMDR therapy, but they comprise just 1 of 8 total stages.
Here are the 8 phases of EMDR you can expect to move through:
- History-taking — Your therapist gathers information about your past experiences, current symptoms, and what you want to work on in treatment. You usually go through this in your first session.
- Preparation — You learn coping skills and relaxation techniques that help you stay grounded when difficult emotions come up.
- Assessment — You identify a specific memory to target, along with a negative belief about yourself (like “I’m not safe”) and a positive belief you want to move toward instead.
- Desensitization — This is where bilateral stimulation begins, and the emotional intensity of the memory starts to decrease over time.
- Installation — Your therapist helps strengthen the positive belief so it feels more true and more connected to the memory.
- Body scan — You check in with your body to notice any remaining physical tension connected to the memory and continue processing if needed.
- Closure — Your therapist helps you return to a calm, stable state before ending the session, often using the relaxation techniques you practiced earlier.
- Reevaluation — At the start of the next session, you revisit the memory to see how it feels now and decide what to focus on next.
Some stages, like history taking, you may only go through once. Others, like closure, you'll go through every session.
How you'll feel during & after an EMDR session
Clients report feeling a lot of different things during EMDR sessions. In some sessions, you might not feel much of anything at all. You might notice the relief later --- you're confronted with something that would usually be triggering, but you find that you're able to handle it with ease.
Often, people feel intense waves of emotions, like:
- Sadness and grief
- Anger
- Fear
- Anxiety
- Shame
These emotions tend to get less and less intense as you move through the session.
Many people experience physical sensations like:
- Tightness in your chest
- A lump in your throat
- Tension in your shoulders or jaw
- A racing heartbeat
- Warm or cold sensations in your body
You may also feel numb or empty during an EMDR session. It may feel hard to really connect to the traumatic memory during sessions, but that's OK.
EMDR is not hypnosis. You will remain alert and conscious throughout the session. You remain in control. If anything ever becomes too overwhelming or you want to stop, you are 100% free to do so. If you start experiencing dissociation during sessions, let your therapist know right away.
Get EMDR therapy in Phoenix & Glendale, AZ
EMDR can be a powerful option if you feel stuck in past experiences that still affect your day-to-day life.
At Thrive, we offer EMDR therapy in Phoenix and Glendale, along with online sessions, so you can access care in a way that fits your life. We’ll take the time to understand what you’ve been through and build a treatment plan that feels manageable, not overwhelming, so you can start to feel some relief.
Get in touch with us today to find a therapist who meets your unique needs! We accept most insurance plans, and have a team of dozens of licensed therapists.
Frequently asked questions
What am I supposed to feel during EMDR?
There’s no single “right” way to feel. Some sessions bring up strong emotions, while others feel more neutral. Many people notice the biggest changes outside of sessions, when something that used to trigger them feels easier to handle.
Does EMDR get worse before it gets better?
Yes, going through EMDR can make things feel more intense at first, especially as you begin to access difficult memories. But your therapist will pace the process carefully and make sure you have tools in place so it doesn’t feel unmanageable.
How long should an EMDR session last?
EMDR sessions typically last anywhere between 50 and 90 minutes.
Who is not suited for EMDR?
EMDR may not be the right fit if you’re currently in an unsafe environment or dealing with ongoing trauma. In those cases, your therapist may focus first on building stability before starting reprocessing work.
Does EMDR work if you can't remember the trauma?
Yes, it can. EMDR doesn’t always require a clear, detailed memory. It can still be effective when you’re working with fragments. But it's important to understand that it's not hypnosis. It's not intended to help you retrieve lost memories.
